On this page, you will find information about antenatal expressing, which means expressing breast milk by hand during pregnancy, before your baby is born.
Please note: This information is intended for clients with whom I have already discussed antenatal expressing or who have scheduled a (telephone) consultation with me.
This is important because I want the information to be tailored to your individual situation. In some cases, this can be medically important. If I have not yet explained this to you personally, please contact me for further guidance.
My main goal is to inform you about options and to offer you an opportunity to gain experience and a useful skill. The amount of milk you collect is not the most important thing, although it is, of course, nice if you are able to collect some. Don't forget to use your newly learned skills immediately after birth if your baby could benefit from a few extra drops to help them wake up or stimulate their appetite.
Please also read the contra indications (situations in which antenatal expressing is not recommended) at the bottom of this page. If you are unsure whether antenatal expressing is suitable for you, please consult me or your healthcare provider.
Thank you!
↓ PDF with instructions (available in English & Dutch) and information about the materials you will need... scroll down.
Antenatal expressing may be particularly beneficial if:
- You have breastfed before and found it (very) difficult, or experienced a low milk supply.
- You have had breast surgery, including a breast augmentation or breast reduction, and plan to breastfeed.
- You have (gestational) diabetes.
- You have a planned caesarean birth.
- You are scheduled for an induction of labour, especially before your due date.
- You have inverted nipples.
- Your baby is expected to need supplemental feeding after birth (for example, because of a congenital condition, prematurity, macrosomia, or another medical condition).
- You have underdeveloped breasts (hypoplastic glandular tissue or so-called tubular breasts).
Learn more
If you would like to learn more about antenatal expressing for parents with diabetes, Dr. Jack Newman (Canada), paediatrician and IBCLC lactation consultant, has written an informative article about the benefits of colostrum for babies born to mothers with diabetes:
https://ibconline.ca/information-sheets/hypoglycaemia-of-the-newborn-low-blood-sugar/
When to avoid or use caution with antenatal expressing
Do not start antenatal expressing without consulting your healthcare provider if any of the following apply to you.
The people listed below were excluded from the DAME study. This means we do not have evidence about the effects or safety of antenatal expressing for these groups. Although it is unlikely that antenatal expressing would have caused problems, it has not been sufficiently studied, so it cannot be recommended without individual medical advice.
This includes people who:
- have vaginal bleeding during pregnancy;
- have a low-lying placenta or placenta previa;
- have high blood pressure during pregnancy;
- have experienced preterm labour or premature contractions in this or a previous pregnancy;
- have had a previous caesarean birth; or
- are carrying a baby with fetal growth restriction (FGR) or who is smaller than expected for gestational age.
If you are unsure whether antenatal expressing is appropriate for you, please discuss it with your healthcare provider before you begin.
Harvesting colostrum (before and/or after birth)
Example video in real life van BabyClinic.co.uk
My name is Marieke van Luin, Lactation Counselor IBCLC. More than 20 years I worked as a midwife. I guide parents in supporting breastfeeding and the challenges that might occur. Do you want to know about me? Read more about me and my approach
Why consider antenatal expressing?
There are several reasons to learn how to express colostrum by hand during pregnancy and to collect your own colostrum before your baby is born.
Colostrum is the first milk your body produces. Your breasts begin making it during pregnancy, long before birth. Often called "liquid gold," colostrum is rich in antibodies, healthy fats, and other protective nutrients, making it the ideal first food for your baby.
Benefits of antenatal expressing
- You become familiar with your breasts and learn the hand expression technique. Practice builds confidence.
- Research suggests that breastfeeding may get off to a smoother start. (However, antenatal expressing does not increase your milk supply after birth—a common misconception.)
- If your baby is unable to feed at the breast immediately after birth, you will have your own precious colostrum available to offer.
Possible disadvantages of antenatal expressing
You may collect only a few drops, or sometimes none at all. This does not indicate how much milk you will produce after your baby is born.
Babies are much more effective at removing milk than hand expression, so trust your body and trust your baby. The aim is not to collect a certain amount of colostrum, but to become familiar with the technique and to build your confidence.
Express gently and stop if it becomes uncomfortable or painful. There is no target amount you need to collect. Try to let go of expectations so you won't be disappointed. Whether you collect a little, a lot, or nothing at all, practising the technique is valuable in itself.
How to express colostrum
Antenatal expressing should be done by hand, not with a breast pump. You can start collecting from 36 weeks of pregnancy (acc DAME study)
Colostrum is produced in very small amounts and is thick and sticky. If you use a pump, much of it is likely to stick to the pump parts instead of being collected. Hand expression is therefore much more effective for collecting colostrum. In addition, the use of breast pumps for antenatal expressing has not been adequately studied, so we do not know whether it is equally safe or effective. Hand expression is also the preferred method during the first few days after birth.
Even if you are not yet able to collect any colostrum, practising the technique is still worthwhile. It helps you become familiar with your breasts and can give you confidence in the days after your baby is born. Many parents also find it helpful to practise together with their partner.
Will I run out of colostrum?
No. Your body will continue to produce colostrum, even if you express some before your baby is born.
Colostrum is the only milk your breasts produce until about 3–4 days after birth. Around that time, your milk "comes in," and you may notice your breasts becoming fuller or engorged as the volume of milk increases. The small amount of colostrum you collect during pregnancy does not reduce what will be available for your baby after birth.
Is antenatal expressing safe?
Yes—hand expression from 36 weeks of pregnancy has been studied extensively in women with diabetes in the Australian DAME Study.
Strictly speaking, the findings apply only to the group that was studied: women with diabetes and no other significant pregnancy complications. For this group, the study found that hand expressing colostrum from 36 weeks onwards was safe and did not increase the likelihood of labour starting.
Managing expectations
Colostrum is produced in very small amounts—often just a few precious drops. Knowing what to expect can help you approach antenatal expressing with confidence.
In the DAME Study, participants collected an average of 5 mL of colostrum (about 1 teaspoon) after expressing up to 20 times. This is a wonderful amount, even though it may be less than many people expect.
The amount collected varied greatly between participants. About 25% collected less than 5 mL in total, while others collected 50–100 mL over the course of approximately 20 expressing sessions. Every drop is valuable, and the amount you collect before birth is not an indication of your future milk supply.
Costs
Most insurances cover costs for lactation support fully or partly.
- Home visit 180/120 euro
- Office/practice 120 euro
- Virtual support 45 euro/30 min
Read more here.